The role of the rheumatologist in managing pain therapy

Despite the clinical importance of pain in patients with rheumatic diseases, rheumatologists have not delegated a proportionate amount of effort to its investigation and treatment. Some of the assumptions that have hindered progress in pain management for rheumatologists include a preference for immunologic research over pain research, a reluctance to provide opioid therapy, and inadequate compensation. Contrary to these assumptions, pain management is becoming an area of increasing research and clinical effort in the field of rheumatology. This article discusses how the barriers to effective pain management can be overcome, although the relative differential compensation for psychosocial versus interventional therapy remains a concern. In the future, rheumatologists will need to expend greater time and effort in the study of pain management to remain pertinent to the needs of their rheumatic disease patients.